OP-ED

The prevalence shortage of nursing globally

By Napolean Bounaparte & Tania Oliveira

Nurses are the largest professional healthcare workforce and maximizing their contribution to health is essential to achieve health coverage for a global ageing population (Coster et al. 2018). The nursing shortage has been recognized as a worldwide problem and is affecting healthcare quality, cost, and effectiveness (Flinkman et al. 2010).

Prevalence of nursing shortage in the USA

The nursing shortage in the USA is not a new phenomenon, in 2000, there was already a 30,000 nursing deficit gap from graduating programs (Baker, 2022). Another contributing factor was the shift from RNs who left their positions and became Nurse Practitioners, and in 2010 the deficit left the US with 80,000 RN vacancies. About 70,000 baby boomer nurses were retiring each year between 2010 and 2020 (Baker, 2022). 

Then in the post-COVID era, many more nurses retired or left the profession (Baker 2022). According to Juraschek et al. (2019), there will be 389 RN jobs unfilled per 100,000 population. In 2030, the prediction is that the western part of the US will have the greatest deficit in nursing staffing, and nationwide there will be over 1 million job vacancies and approximately 18 million deficit of nurses globally.

Texas is the state with the highest prediction of a nursing shortage with 15, 900 job vacancies in 2030 (Spurlock, 2020). As a consequence, low quality of care, remaining nurses burn out and poor patient outcomes are likely to increase (Baker, 2022).  Coming together as administrators, nurses, and policymakers to discuss in this post-COVID era how to move forward in a way that is beneficial to all is crucial to retain the maximum amount of nurses in the workforce and bring new ones into this estimated profession (Baker, 2022). 

Nursing Shortage in Uganda 

Uganda is one of the 56 countries in Africa. Africa bears 25% of the world’s disease burden and has only 3% of the world’s health workforce. Low and middle-income countries have severe nursing staff shortages which are associated with heavy workload, risk of poor quality of patient care, and increased patient exposure to adverse events like musculoskeletal disorders to the nursing staff. 

Uganda produces about 5000 nurses yearly but according to the Uganda nurses and midwives’ union president Mr. Justus Cherop, Uganda only employs 2000 nurses leaving the 3000 nurses unemployed. The question is why do we complain about nursing shortage? You and I seem not to have the best answer but this is attributed to a few challenges listed in this article.

The research was done in Uganda in 5 hospitals which included one private hospital and the shortage of nurses was found to be at 6 nurses per 100,000 population compared to the USA which has 773 nurses per 100,000 Population which is below the WHO recommendation and most hospitals including Mulago National Referral suggested to change nurses shifts from 8 hourly to 12 hourly to allow nurse have sufficient time with their family members (Munabi et al. 2014). Additionally, nurse to patient ratio in Uganda is 1:11000 which is an acceptable standard (Mwesigwa et al, 2020).

In Uganda, 80% of the population lives in the rural areas which the majority of the nurses do not reach, therefore the majority of the nurses want to live in urban settings because there is access to better standards of living like accessibility to good roads, social services like internet and recreational centres (Anyango, 2022). 

Some commonalities causes of nursing shortage in both the USA and Uganda include;  Mal-distribution of health workers – supply and demand, Geographical hindrances (infrastructure development), Poor funding for health care budgets, Lack of Job opportunities for BSN-prepared nurses in Uganda, Brain drain- Burn out, Emerging infectious diseases, Poor motivation of the staff: lack of control, nurse leadership, Poor working conditions- USA, schedule of working holidays and nights, and Lack of or shortage of supplies (Things needed to give the best care).

Recommendation

This information does not only benefit the researchers in the academic world but also policymakers, administrators, managers, and patients whose care delivery is improved as the problem is addressed. In this post-Covid 19 era, Policy makers, therefore, should ensure proper strategies of recruitment and selection, better allocation of funding, appropriate labor division, nurse motivation, and generally improve infrastructures to boost chances of retaining nurses and other health workers (Baker, 2022).

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The authors are; RN Napoleon Bounaparte – Aga Khan University Alumni, Murchison Bay Hospital Luzira, and RN Tania Oliveira– Case Coordinator, University of Utah USA.



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